Two years ago, when 75-year-old Shirli McLaughlin had a minor medical emergency, she headed across the hills from Felton, where she lives, to Sutter Health’s Urgent Care facility on Scotts Valley Drive.
“I was grateful to have a place to go that was so close,” she says.
Now that Sutter Health is transforming their Scotts Valley facility from urgent care to family medicine and pediatrics—with some same day appointments—McLaughlin says she’s concerned. “I would have had to go all the way to Dominican.”
Sutter Health plans to make the switch Aug. 30. It’s also reopening its Westside Urgent Care location at 1301 Mission St. in Santa Cruz. But the health giant is having a hard time bringing in doctors—as company officials confirmed during a virtual Q&A involving Sutter Health and community members on July 26. The one-hour meeting was hastily organized after local congressional representative Anna G. Eshoo, who chairs the health subcommittee of the House of Representatives in Washington, D.C., put pressure on Sutter CEO Sarah Krevans to host one.
A few days earlier, when Good Times reached Eshoo, she’d just emerged from a Capitol Hill mark-up session that touched on Medicaid, the opioid crisis, and children’s vaccinations. She says she was troubled to hear Sutter was decreasing access to health care for residents in her district.
“This issue is deeply upsetting to people,” says Eshoo. “This really landed like a bomb in the community.”
Eshoo says she feels like the issue was “mishandled” and revealed she’d just met with top Sutter brass to push for the community meeting. She asked them to explain why some residents will be forced into crosstown traffic to reach other urgent care destinations.
“Being struck in traffic with a 45-minute drive doesn’t fit with the word ‘urgent,’” she said. “Their patients deserve better.”
During the Monday evening Q&A, in response to a question about transparency, Dr. Lawrence DeGehtaldi, president of the Palo Alto Medical Foundation Santa Cruz at Sutter Health, apologized for not including patients in the decision-making process.
“That is a fair point,” he said. “I’m sorry.”
Sutter, through the affiliated nonprofit Palo Alto Medical Foundation, serves one million patients across San Mateo, Santa Clara, Alameda and Santa Cruz counties.
During the livestream, patients weren’t given the opportunity to speak, instead submitting written questions. Officials claimed financial concerns weren’t at the heart of their shifting of local health priorities.
Instead, administrators said, it represents a strategic realignment, as the health system plans for an influx of more than 5,000 new potential patients to the area.
Dr. Rebecca Barker, Sutter’s chief physician in Santa Cruz County, tried to impress upon virtual attendees the difficulty involved in attracting physicians.
“There’s not been enough primary care doctors,” she said. “That has been a big challenge for me. I’ve had to figure out how to get you all primary care doctors.”
Dr. Chris Bernardi, who’s worked at the Scotts Valley Urgent Care Center, said in many ways the location already functions as a de facto family medicine facility and pointed to staffing challenges.
“You can see all the development popping up in Scotts Valley proper and in the surrounding communities,” he said. “I’m doing everything I can on my end to bring in new patients.”
Sutter plans to reduce hours at the location from 8am-5pm seven days a week to 8am–5pm on weekdays, but will still take same-day appointments. Officials pledged doctors would continue to take on evening and weekend work, but wouldn’t commit to forcing them to do this, suggesting it would make retaining employees harder.
And that would be a problem, Barker said, since it’s competitive right now to attract family physicians.
DeGehtaldi said the services Sutter is bringing to Scotts Valley will better serve people with behavioral and mental health issues—like an anxiety attack—care which has been increasingly required during the pandemic, particularly after the CZU Lightning Complex fire.
Barker said the vast majority of these cases aren’t handled by urgent care doctors or psychiatrists, but by primary care physicians. That’s all happening online now, since the coronavirus showed up, she added.
With its Westside Center Urgent Care location reopening, the tension in the system will be easing shortly, Barker says.
“I’m not saying that the Scotts Valley patients will ultimately go there,” she said, adding another problem is health care workers who spent a year-and-a-half on the frontlines of the pandemic are taking “well overdue vacations” this summer.
When a community member asked about the problem some people have encountered in which their insurance plans charge them more money to get primary care or to visit the emergency room than if they were to go to an urgent care location, DeGehtaldi brushed off the concern.
“The standard office visit charges are the same,” he said, suggesting urgent care actually costs more with some insurance providers. “Sutter’s support for this community has been strong and important.”
When the same questioner claimed Sutter was removing care options in the area, DeGehtaldi disagreed. He pointed to Palo Alto Medical Foundation’s expansion from three county sites to almost 20 in recent years.
But he conceded there is one big gap in their Santa Cruz County strategy: the San Lorenzo Valley.
Scotts Valley City Councilman Randy Johnson said DeGehtaldi was invited to attend a small gathering of patients two days earlier, but didn’t show up. There, multiple area residents shared about situations where urgent care saved their lives.
“It just keeps piling on that this has been and will be a top-down decision, with zero collaboration,” Johnson said. “It’s business for them. It’s personal for us.”
Johnson said Sutter needs to stop complaining about Kaiser Permanente not taking a bigger share of poor, government-covered patients and come up with effective care solutions.
“They’re kind of taking the easy way out,” he said. “You have problems? Be creative.”